CMS requires some providers to participate in the Medicare Accountability and CHIP Reauthorization Act, with final regulations released in October 2016. Those who don't participate in MIPS face a penalty. However, according to a Medscape report, many providers don't know whether they're eligible or excluded from MIPS.
MIPS applies to physicians who have $30,000 or more in annual Medicare revenues; but as physician groups consolidate it's unclear whether individual providers in a larger group who wouldn't otherwise qualify now do because their partners meet the threshold. The reporting only applies to patient-facing physicians, but the agency hasn't clarified whether hospital-based specialists like radiologists and anesthesiologists are patient-facing or not.
The Medical Group Management Association sent a letter to the newly elected CMS administrator Seema Verma asking for clarifications; the agency responded providers will be notified this spring. However, those who are watching closely are skeptical, as the agency was supposed to notify providers by the end of 2016.
Clinicians who are unsure of their status can choose the minimum reporting option in CMS' "pick your pace" approach, which allows providers to report on a single quality or practice improvement measure to avoid 2019 penalties. But other practice decisions could also depend on the status clarification, according to MGMA Senior Vice President of Government Affairs Anders Gilberg.